The staff ratio is 1:5 with limited personal care, behavior management and feeding support available.

The camp is for participants with a physical disability.

Fields marked with an * are required

*Payment is due at time of registration in order to confirm your place.

Credit card payments can be made over the phone (MC or VISA). Cash or cheques are accepted at the Nature Centre, Mon-Fri 9:00-4:00. Refund and Payment Policies are available on our website.

Program Participant Profile

Emergency Contact Information

Emergency Contact (other than parent/guardian)

Permissions Granted

Name & phone of those allowed to pick up/sign your child out of camp (if unfamiliar to our staff, they may be asked to show picture I.D.):

Health Card/Special Needs Information

If yes, you will need to complete the Medication Administration Request Form.

Activities of daily living.

Please check the level of assistance required for each task.


I hereby give the staff and volunteers of Heartland Forest full permission to use the information provided in this form for helpful program and service delivery. The information I have provided on this form is true and accurate to the best of my knowledge.

Participation Waiver

Image Release
My child has permission to participate in media coverage and photographs at Heartland Forest Nature Experience. I hereby grant Heartland Forest the right and permission to publish photos for the purpose of, without limitation, television, publication, and trade or advertising purposes. Accordingly, I release and discharge Heartland Forest staff & respective board members from any liability by virtue of blurring, distortion, alteration, optical illusion or use of composite from that may occur or be produced in taking of said media or any processing through completion of the finished product.

Emergency Medical Consent
By enrolling my child in any Heartland Forest day camp or other program/activity, I hereby authorize the procurement of whatever emergency medical treatment may be necessary for my child. I also authorize the removal of my child from camp premises for the purpose of obtaining such emergency medical treatment if the need so arises. I agree to hold Heartland Forest Nature Experience harmless for the nature, performance, and outcome of any such emergency medical treatment and that the determination of whether an emergency has arisen shall be left to the sole discretion of Heartland Forest Nature Experience.

Acknowledgement & Assumption of Risk
The participant and parent or guardian acknowledge that they are aware of the details of camp and that there exists an element of personal risk or damage of serious injury in the activities and willingly agrees to assume responsibility for those risks as a condition of registering for the program.

Indemnification & Release
I hereby represent that my child has no physical restriction which would prohibit his/her participation in the activities of camp. On behalf of my child I save and hold harmless Heartland Forest Nature Experience or any of their agents, representatives, employees or assigns for my child’s health, safety, or any injury and/or disability arising out of or resulting from program activities.

I acknowledge and have read, understood and agree to the above Waiver, Release and Indemnity. I hereby understand that my child will follow the rules and regulations as set out by the organizers of the camp, and that by not adhering to the rules and regulations, he/she may not only endanger himself/herself, but permission may or will be revoked and he/she will be asked to leave the premises.


I have read and agree to this waiver and indemnity.